Hormonal Acne

What is hormonal acne?

Most of the acne we are familiar with is hormonal acne, also known
as acne vulgaris. Most simply, it is acne that develops due to hormonal changes
and imbalance, usually as a result of there being too much male hormone, or
testosterone. Testosterone increases how much oil the skin secretes, which can
lead to clogged pores. These can then be colonised by a bacteria known as Cutibacterium acnes, irritating the skin
cells and leading to inflammation.

Hormonal acne is most common in teenage years when our bodies are
undergoing many changes, but can arise at any time in your life.

Is there a difference between acne, hormonal acne, acne during puberty and acne vulgaris or are they all the same thing?

While the reasons for someone getting acne might differ, all acne is
caused by excessive oiliness of the skin. While some people may normally have
oilier skin, unexplained and regular bouts of acne all point to the same
underlying causes – insulin resistance and hormonal imbalance. So while you
have heard of different names, these acnes are actually the same. It should be
noted, though, that hormonal change at certain times of one’s life, like
puberty, is normal, even if uncomfortable, while at other times may point to a
bigger problem.

How are acne, insulin and my hormones linked?

Insulin and hormone balance are tightly connected. When insulin
becomes too high, it is able to suppress the action of female hormones, and
enhance that of male hormones. At the same time, male hormones, like
testosterone, are able to cause insulin resistance. What this leads to is a
snowball effect where hormones become more imbalanced and insulin resistance
increases.

Male hormones are also responsible for causing higher amounts of oil,
or sebum, production in the skin, especially on the face. This leads to
blocking of pores and the development of acne.

I’ve already undergone puberty or am an older adult, what does it mean if I still suffer from acne break-outs?

Experiencing acne past puberty is not so rare that you should be
worried, especially if you only get a few spots every now and then. Acne can be
caused by many things, and you should try and figure out what is associated
with spots. If you’ve tried your best, however, and either can’t find any link,
or your acne is persistent, it may be worth considering that underlying
hormonal imbalance or insulin resistance may be the cause.

I only get acne a few times a year, should I be worried about PCOS, insulin resistance or hormonal imbalance?

If your acne occurs only intermittently, without any other symptoms,
it is not likely caused by chronic insulin resistance or hormonal imbalance but
more likely some lifestyle factor like stress or a poor diet during the
holidays. That even intermittent acne might be a sign of some underlying condition,
however, should not be ruled out. This is especially the case if you experience
any of the other symptoms of insulin resistance or hormone imbalance.

What are some symptoms of insulin resistance or hormonal imbalance that I should be especially aware of?

Insulin resistance and hormonal imbalances go hand-in-hand, and so
signs of symptoms of the one can point to the other. If you experience any of
the below, especially in combination with acne, it may be prudent to consult
with your doctor:

How can I address my acne and what are the treatments?

Acne can be caused by many things, but ultimately is a result of
excessive oiliness of the skin leading to blocked pores, invasion by the
bacteria C. acnes, and ultimately,
inflammation. Treatment for acne should therefore be multi-layered, focussing
on the underlying cause of oily skin, prevention of pore blockage and
suppressing inflammation in the skin. In any of these cases, however, the
over-bearing evidence is that acne can be significantly reduced by adopting
positive lifestyle modifications.

Maintaining a healthy weight. Weight loss can reduce insulin and androgen levels and may restore ovulation. Even slight reductions (as little as 5%) can make a difference and improve fertility.